Every April, the world observes Cesarean Awareness Month, an event that aims to highlight the overuse of a surgical intervention that allows a baby to be born through an incision in the mother's abdomen, and to advocate for respectful and humanized cesarean sections—something that, unfortunately, does not always happen.

In its recommendations, the WHO considers a cesarean rate of between 10% and 15% of all births. However, the cesarean rate in Europe is 25.2%. In Spain, this figure rises even further, up to 26.46%, meaning that more than one in four births in our country are by cesarean.

In this regard, it is worth remembering that institutions such as the WHO or the UN consider the practice of unjustified cesarean sections to be a normalized form of obstetric violence against women. Notably, this very March, the UN reproved Spain for the third time for exercising obstetric violence against a woman.

When should a cesarean section be performed

Although, as we have said, cesarean section is now a common practice in many hospitals around the world, according to the WHO this surgical intervention should only be performed as a resource “when vaginal delivery poses a risk to the mother or the baby”. That is, for example, when there is fetal distress, when the baby is in an abnormal position that complicates vaginal delivery, or when labor is prolonged excessively without progress. In this last case, a cesarean would only be advisable if the lack of progress put the life of the mother or the baby at risk. In other words, it would not be necessary if the lack of progress is accompanied by a normal fetal monitor. In any case, it should be a respectful and humanized cesarean.

In addition to these resource cesarean sections, there are also the so-called elective cesarean sections, which are planned procedures performed on pregnant women who have a maternal or fetal condition that contraindicates or advises against a vaginal delivery. However, this concept of “elective cesarean” has given rise to what associations like El Parto es Nuestro call “an unhealthy trend,” which involves scheduling cesarean sections without medical justification. This is a fairly common practice among celebrities and has spread among the population.

In this sense, it is worth remembering that, although it is generally a safe procedure, like any surgical intervention, a cesarean section is not without risks. These include the possibility of damaging nearby organs, infections, hemorrhages, the formation of blood clots, and the fact that it involves a longer recovery process than that required after a vaginal birth.

This is what a respectful and humanized cesarean section should look like

To achieve a respectful and humanized cesarean section, a series of basic requirements must be met. The first, which is obvious given what we have discussed so far, is that the intervention is medically justified as essential and unavoidable. The second is that the woman is informed in detail and in an understandable way about the reason for the intervention and its pros and cons, so that, based on that information, she can give her approval (or not).

Starting from this essential premise, the ultimate goal of a respectful and humanized cesarean section should be to try to imitate, as much as possible, the scenario of vaginal birth.

And what does this imply? Among other things, allowing the active participation of the father (or the companion the mother wishes to have by her side during the process) and of the mother herself, and ensuring that the baby's birth is as smooth and physiological as possible. This means avoiding separation of the mother-baby dyad after birth and promoting skin-to-skin contact from the very first moment, given its many benefits for the mother (stabilization of heart rate, fostering the bond of breastfeeding, reduction of postpartum depression incidence, etc.) and for newborns (better adaptation to extrauterine life, improved temperature control and regulation, better heart rate, etc.).

Benefits of a respectful and humanized cesarean section

We have already discussed in the previous section one of the main benefits of a respectful and humanized cesarean section: promoting skin-to-skin contact between mother and baby, which, as we have seen, has a very positive impact on many levels for the two main protagonists of childbirth. But this is not the only benefit—far from it. Among many others, we can also mention the following:

• Less anxiety from mothers: Let's not forget that a cesarean section is a surgical procedure, with the tension that any operation entails. Being able to be accompanied and emotionally supported (whether by your partner, mother, or a friend) helps improve the experience of the procedure and to go through it with less stress and anxiety.

• Respect for the times: Unlike what happens in a conventional cesarean, in a respectful and humanized cesarean, the emotional state of the mother and baby is given great importance, and the timing is respected to support the baby's physiological adaptation and the formation of the mother-child bond.

• Postpone the clamping of the umbilical cord: Nowadays, there is already ample scientific evidence of the health benefits for the baby of delayed umbilical cord clamping, including a greater supply of stem cells and hemoglobin, a lower risk of anemia during the first year of life, and a lower risk of hypoxia at birth.

Considering its many benefits, and the fact that scientific evidence shows it does not increase the usual risks of any cesarean section, at LILLYDOO we can only join the call for a respectful and humanized cesarean. And you—will you join too?